PARAMETERS | PRE-IMPLEMENTATION DATA | POST-IMPLEMENTATION DATA | |
---|---|---|---|
Rectal cancer program director and coordinator | Yes | Yes | |
A defined Rectal cancer multidisciplinary team with a lead physician member from each specialty. | Established but no lead physicians appointed. | Yes | |
Rectal cancer multidisciplinary team meetings with the attendance requirements | No strict requirements (At least one physician of each specialty was present) 100% | Yes 100% | |
Review of diagnostic pathology (95% of previously undiagnosed, previously untreated rectal cancer patients must undergo a biopsy at the Rectal cancer program for confirmation of rectal cancer diagnosis. | 60% | 100% | |
Internal medical record review | 100% | 100% | |
Clinical staging before definitive treatment with CT or PET/CT scan of the chest, abdomen, and pelvis, and MRI of the pelvis | MRI: 68% CT or PET: 96% | 100% | |
Standardized staging reporting for MRI of the pelvis highlighting the depth of tumor penetration into the mesorectum, status of the circumferential resection margin, involvement of adjacent organs, lymph node involvement, extramural venous invasion, and relation to the anal sphincter complex. | Variable. Some MRI were interpreted by radiologists without special training on rectal specimens. Some MRIs were performed in outside institutions without a standardized format. | 100% of MRIs are read by a radiologist who is a member of the Rectal Cancer Multidisciplinary Team. 100% of all the MRI reports have a standardized format containing all required elements. | |
CEA levels | 100% | 100% | |
Rectal cancer multidisciplinary team treatment planning discussion | 100% | 100% | |
Treatment evaluation and recommendation summary | 100% | 100% | |
Definitive treatment timing (within 60 days of patient’s initial clinical evaluation). | >90%** | 100% | |
Surgical resection and standardized operative reporting. | No prior standardization protocol | 100% Rectal cancer surgeries are performed by a member of the Rectal cancer multidisciplinary team. | |
Adequate fixation time | 15% | 100% (48-72 hours in average) | |
Pathology reports (95% of the specimens are read by a pathologist who is an appointed member of the Rectal Cancer Multidisciplinary Team. Reports are completed within 2 weeks. | 93% reports completed within 2 weeks | 100% | |
Cancer summary with the pathological parameters required by the National Accreditation program | 100% | 100% | |
Multidisciplinary team post-surgical treatment outcome discussion | 100% | 100% | |
Post-surgical treatment outcome discussion summary | 100% | 100% | |
Adjuvant therapy after surgical resection (within 8 weeks of definitive surgical resection). | ** | 100 | |
Rectal cancer program education (CAP protocols and Supplemental education materials are provided by the NAPRC) | NAPRC’s supplemental education materials became available on October 2017 | 100% | |
**variable considering referral cases from outside institutions